What is Diabetes?

Today, India has an estimated 65.1 million people with diabetes. This is the second highest in the world, after China which has an estimated 98.4 million people with diabetes.*

Diabetes is a condition which occurs as a result of problems with the production and supply of insulin in the body. Most of the food we eat is turned into glucose, a form of glucose. We use glucose as a source of energy to provide power for our muscles and other tissues. Our bodies transport glucose in our blood to muscles and tissues. In order for our muscles and other tissues to absorb glucose from our blood, we need a hormone called insulin. Without insulin, our bodies cannot obtain the necessary energy from our food.

Insulin is made in a gland behind the stomach called the pancreas. It is released by cells called beta cells in the pancreas. Insulin allows the entry of glucose from the blood into the cells and thus becomes necessary for the body to be able to use glucose for energy. When we eat food, the body breaks down all of the glucoses and starches into glucose, which is then used for energy.

When a person has diabetes, either his/her pancreas does not produce the insulin he/she needs, or the body cannot use its natural insulin effectively. Thus, in diabetes, when the glucose builds up in the blood instead of going into cells, it can cause following problems: the cells may be starved for energy and over time, high glucose levels in the blood may cause damage to eyes, kidneys, nerves and/or heart.

Diabetes Symptoms:

Type 1 Diabetes Mellitus

Type 1 diabetes is sometimes called insulin-dependent, immune-mediated or juvenile-onset diabetes. Type 1 diabetes is usually diagnosed in children or young adults, although it can occur at any age. Approximately 5-10 % of all people with diabetes are diagnosed with Type 1.

Type 1 diabetes is caused by an auto-immune reaction where the body's defence system attacks the insulin-producing cells. The reason why this occurs is not fully understood. People with type 1 diabetes produce very little or no insulin.

The onset of type 1 diabetes is often sudden and can include the following symptoms:

Abnormal thirst and a dry mouth

Frequent urination

Extreme tiredness/lack of energy

Sudden weight loss

Slow-healing wounds

Recurrent infections

Blurred vision

People with this form of diabetes need injections of insulin every day in order to control the levels of glucose in their blood and enable entry of glucose from the blood to the cells. A person with type 1 diabetes supplies his/her body with insulin in one of the following ways:

Insulin pump

Insulin pen

Insulin injections with a syringe

Insulin therapy along with a healthy meal-plan, regular physical activity and frequent blood glucose testing are important in the management of type 1 diabetes.

Type 2 Diabetes Mellitus

Type 2 diabetes is sometimes called non-insulin dependent diabetes or adult-onset diabetes. Type 2 diabetes is the most common type of diabetes and accounts for 90-95% of all diabetes. While Type 2 diabetes traditionally affects people later in life, it can affect people at any age. It is most common in people older than 45 who are overweight. However, as a consequence of increased obesity among the young, it is becoming more common in children and young adults.

In type 2 diabetes, the pancreas may make enough insulin, but the body cannot effectively use the insulin it creates. This is known as insulin resistance. Eventually, the pancreas may stop producing insulin altogether.

If people with type 2 diabetes are not diagnosed and treated, they can develop serious complications, which can result in an early death. Worldwide, many millions of people have type 2 diabetes without even knowing it. Others do not have access to adequate medical care.

Risk factors or characteristics for type 2 diabetes include:

Family history of diabetes

History of gestational diabetes

Obesity

Physical inactivity

Unhealthy diet

Race/Ethnicity

Because type 2 diabetes develops slowly and is often hard to detect, many people are not diagnosed until various complications appear. One-third of all people with diabetes may be undiagnosed.

Depending on its severity, type 2 diabetes can be managed through diet, physical activity and medications, both oral hypoglycemic agents and possibly insulin injections. Often, a combination of different medications are prescribed. People with type 2 diabetes do not usually require insulin injections when first diagnosed but may require insulin injections if oral agents have shown to be ineffective. Self-monitoring of blood glucose can help measure the success of therapeutic interventions.

Gestational Diabetes

Some women develop a third, usually temporary, type of diabetes called 'gestational diabetes' when they are pregnant. Gestational diabetes develops in 2-5% of all pregnancies but usually disappears when the pregnancy is over. Women who have had gestational diabetes have an increased risk of developing type 2 diabetes later on.

Gestational diabetes occurs when pregnancy hormones and weight gain block a woman's body's ability to use insulin properly. This type of diabetes can affect women who have never had diabetes.

Gestational diabetes can lead to high blood pressure for the mother and high birth weight for the child.

Although this type of diabetes usually goes away after the child is born, there is also an increased risk of developing type 2 diabetes for both mother and child in the future. Your child may also be at higher risk of childhood obesity.

These risks can be reduced by maintaining a reasonable weight, staying physically active and making healthy food choices. Breast-feeding may lower your child's risk for type 2 diabetes as well. See your healthcare professional to create a management plan that is right for you and your child.

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